39例新型冠状病毒肺炎患者的临床特点及疗效分析

Clinical characteristics and effect analysis of 39 cases of 2019 novel Coronavirus-related pneumonia

目的探讨新型冠状病毒肺炎(COVID-19)临床特点及治疗效果,为临床诊疗提供依据。方法收集太原市第四人民医院2020年1月21日至3月5日收治的确诊为COVID-19的患者39例作为研究对象。收集并分析研究对象的流行病学特征、人口学特征、临床表现、实验室和胸部CT检查结果、治疗方案及效果评价。结果患者年龄中位数(四分位数)[M(Q1,Q3)]为58(37,68)岁,男25例(64.1%),女14例(35.9%);33例(84.6%)患者有明确的与COVID-19患者的接触史。23例(59.0%)为聚集性患者。临床症状以发热最常见[30例(76.9%)],其次为咳嗽[24例(61.5%)]、咳痰[17例(43.6%)]、胸闷及呼吸困难[11例(28.2%)]、乏力[10例(25.6%)]、纳差[4例(10.3%)]、流涕[3例(7.7%)]、鼻塞及咽干咽痛[2例(5.1%)]、肌肉酸痛[1例(2.6%)]。胸部CT扫描提示双侧多发病灶[34例(87.2%)],单侧病灶[5例(12.8%)],阴影多位于肺外带。自发病到咽拭子核酸检测阴转时间的M(Q1,Q3)为15(11,19)d。胸部CT扫描所见病变从发病到消散期时间的M(Q1,Q3)为17(14,19)d。39例患者全部治愈出院,2~4周后随访无复阳。结论COVID-19患者多为聚集性发病,症状以发热、咳嗽、咳痰、胸闷、呼吸困难、乏力为主。胸部CT检查有重要的诊断价值。在抗病毒治疗基础上,应用氧疗及适当采用糖皮质激素治疗有助于减轻症状,改善预后。

Objective To investigate the clinical characteristics and therapeutic effects of the coronavirus disease 2019(COVID-19),and provide evidence for clinical diagnosis and treatment.Methods 39 patients diagnosed with COVID-19 who were admitted to Taiyuan Fourth People’s Hospital from January 21 to March 05,2020 were collected,the epidemiology,demographic characteristics clinical manifestations,laboratory examination,chest CT features,treatment plan and effect evaluation were analyzed.Results Median age(quartile)(M(Q1,Q3))was 58(37,68),25 males(64.1%),and 14 females(35.9%).33 cases(84.6%)had a clear exposure history of contact with COVID-19 patients,23 cases(59.0%)were clustered patients.The most common clinical symptoms were fever(30 cases(76.9%)),followed by cough(24 cases(61.5%)),expectoration(17 cases(43.6%)),chest distress or dyspnea(11 cases(28.2%)),fatigue(10 cases(25.6%)),inappetence(4 cases(10.3%)),runny nose in(3 cases(7.7%)),nasal obstruction and pharyngeal dryness and pharyngalgia(2 cases(5.1%)),and muscle soreness(1 case(2.6%)).CT features showed that bilateral multiple lesions(34 cases,87.2%)and unilateral lesions(5 cases,12.8%),and the shadows were mostly outside the lung.The median days(quartile)(M(Q1,Q3)),from the onset to the negative of the nucleic acid test of the pharyngeal swab negative,were 15(11,19)days.Chest CT features of the lesions from onset to dissipation were 17(14,19)days.All 39 patients were cured and discharged from hospital,and no recurrence was found in the follow-up after 2 to 4 weeks.Conclusion Most of the COVID-19 patients are cluster cases,and the main symptoms are fever,cough,expectoration,chest distress,dyspnea and fatigue.Chest CT features have important diagnostic value.On the basis of antiviral therapy,oxygen therapy and appropriate glucocorticoid therapy can help reduce symptoms and improve the prognosis.